Allison Proffitt, Digital HealthCare & Productivity staff
October 14, 2008 | A proposed rule from HHS requiring all physician practices and other providers to adopt a new coding set – the ICD-10 code set – by 2011 would dramatically increase costs for physician practices and clinical laboratories, according to a new cost study initiated by a broad group of provider organizations and conducted by Nachimson Advisors. Armed with this new information, these groups call on the US Department of Health & Human Services to carefully reassess its plan to rapidly adopt ICD-10 and extend the implementation time frame. The costs associated with implementing ICD-10 in such a short timeframe, are markedly higher than what CMS has estimated and will place a major burden on providers, taking valuable time away from their patients and straining other resources needed to invest in health information technology. Cost estimates for practices and laboratories to implement ICD-10 were highlighted in the study. The total estimated cost for a 10-physician practice to move to ICD-10 would be more than $285,000. For a small, three-physician practice, the total cost to implement ICD-10 is estimated to be $83,290, for a large, 100-physician practice the estimated costs to implement ICD-10 is more than $2.7 million. View fact sheet of study findings.
Iron Mountain will begin offering a diagnostic assessment that shows the nation’s largest hospitals how to process patient records more efficiently, speeding care and shortening revenue cycles. The diagnostic tool is part of Iron Mountain’s shift toward a more consultative approach in the health care space and is the latest in a string of recent moves by the company to support health care providers’ drive to lower costs while improving patient care. Generally taking 3-4 weeks to complete, the assessment helps health care organizations to automate workflows and fund the transition to electronic health records by identifying inefficiencies in their current medical records management practices. The assessment is designed for large teaching hospitals and multi-hospital health care networks, where numerous file rooms and records storage vendors create the need for greater efficiency.
HIMSS Analytics and the American College of Clinical Engineering have agreed to jointly conduct an ongoing research study of medical devices in American hospitals to evaluate patient safety and quality care benefits of medical devices that share data with EMRs. As part of this research process, HIMSS Analytics will be creating benchmark reports for hospitals that complete the survey so that these organizations can more clearly compare their operations to peer hospitals. This information can be used to review and defend allocations for both operating and capital budgets for the clinical engineering/biomedical operations. According to the agreement, the two organizations agree to collaborate in developing and conducting a census survey of mutually agreed-upon questions directed at hospital corporations regarding the collection of IT application information in US hospitals, initially those above 150 beds.
Honoring excellence in the implementation of electronic health records (EHRs), the Healthcare Information and Management Systems Society (HIMSS) announces the recipients of the 2008 Davies Awards in the Organizational, Ambulatory and Community Health Organization categories. The HIMSS Nicholas E. Davies Awards of Excellence Program honors achievement in the implementation and use of health information technology, specifically electronic health records, for health care organizations, private practices, public health entities, and community health organizations.
Organizational: In 2008, one health care organization received the Davies Award in this category:
- Eastern Maine Medical Center - EMMC serves communities in central, eastern and northern Maine. An EHR system was implemented as part of EMMC’s Patient First Initiatives Program, a tri-fold approach to delivering high quality patient care by transforming care delivery, adopting a patient-focused culture and implementing a technology plan to support the care delivery process. EMMC’s use of data derived from its health care IT systems is a shining example of how to drive performance improvement, quality and improve care in response to state and national reporting requirements.
Ambulatory: Three medical practices received the HIMSS Ambulatory Davies Award of Excellence demonstrating the value and benefits of the EHR in serving the patient care needs of these diverse patient populations:
- Palm Beach (Fla.) Obstetrics and Gynecology PA—Serving a predominantly suburban region, the practice had been using a computerized scheduling, billing and collections system. Its EHR system has improved patient care by reducing delays in reviewing labs and radiology reports and making clinical information accessible to providers on nights and weekends, critically important to delivering babies.
- Oklahoma Arthritis Center—Located near Oklahoma City, the center treats patients with arthritis and related conditions such as lupus and osteoporosis. The center supports a “single patient, single record” concept as the best option for patients’ health. A goal of its EHR implementation: to prepare for the future integration of a National Health Information Network.
- Cardiology Consultants of Philadelphia, P.C.—CCP has 21 office locations, extending over four counties in southeastern Pennsylvania, and is the second largest cardiology practice in the country. The practice benefited from implementing an EHR system, including improving patient care, reducing filing and transcription costs, reducing malpractice exposure and costs and analyzing individual and group practice patterns, leading to an improved bottom line.
Community Health Organizations (CHO) and Member CHOs: As a new award category in 2008, the HIMSS Davies Community Health Award recognizes care being provided through an open-door policy, predominantly to underserved populations:
- Columbia Basin Health Association - Comprised of three clinics in central Washington, CBHA provides many services including medical, dental, vision, lab, maternity and behavioral health. A majority of CBHA’s patients are migrant/seasonal workers, uninsured and well below the federal poverty level. Implementing an EHR has supported CBHA’s philosophy of “If you can measure it, you can manage it.”
- White River Rural Health Center - Through its primary care clinics, dental clinics, pharmacies and wellness centers, WRRHC treats a diverse patient population in rural Arkansas. Services include education and prevention programs. Striving to offer a “Total Care” system, WRRHC implemented an EHR; patient information is now integrated across 20-plus sites, resulting in greater continuity of care. New York Children's Health Project - New York Children's Health Project - NYCHP, a program of Montefiore Medical Center and the Children's Health Fund, provides primary care services to homeless, medically underserved and severely disadvantaged children and families. Health care teams deliver care throughout NYC via custom-designed mobile medical units and at on-site shelter clinics, and an EHR is tailored to meet the specific needs of its unique patient population.
- Community Health Access Network and Member CHCs - CHAN, a Health Center Controlled Network, supports five member CHCs in New Hampshire providing primary care services, including pediatrics and prenatal. A majority of members also provide dental and behavioral health care. CHAN's EHR system has been a vital tool in improving patient care and outcomes for large patient populations. With the core implementation complete, CHAN has focused on wraparound tools that enhance the capabilities of its EHR. These tools include document scanning, a secure portal to facilitate exchange of information with patients and external providers, integrated support care devices for vitals and EKGs, chart viewing capabilities for hospitalists and emergency department physicians, as well as interfaces with numerous hospitals and independent labs.
Commonwealth Care Alliance, a not-for-profit care delivery system in Massachusetts, will employ Casenet’s case management solution to more effectively manage its members’ care. The Casenet platform fosters collaboration and communication between direct care providers and Commonwealth Care Alliance. In doing so, Commonwealth Care Alliance fulfills its promise to provide responsive, continuous and cost-effective medical and social services for people with complex medical needs. Casenet will provide Commonwealth Care Alliance member services staff, enrollment staff and care managers as well as the provider network with a single data source for thorough and up-to-date patient information to aid in more accurate and efficient decision-making. By integrating the claims payment system and replacing enrollment and care management systems with Casenet, Commonwealth Care Alliance will benefit from a centralized, cross-disciplinary design that increases efficiencies and collaboration, thereby improving care recommendations and overall health outcomes, and better managing health care costs.
CCHIT has announced that McKesson's Practice Partner Patient Records 9.3 software complies with updated interoperability requirements, is CCHIT Certified 2008 Ambulatory EHR, is additionally certified for Child Health, and meets the Certification Commission's electronic health record (EHR) criteria for office-based use. In addition to complying with updated interoperability requirements required to achieve certification, Practice Partner Version 9.3 has also received CCHIT’s 2008 specialty certification for Ambulatory and Child Health. The Practice Partner software earned this certification by fulfilling all of CCHIT’s clinical and administrative requirements specific to child health practices. This is first time that CCHIT has provided certification of EHRs for specialties. McKesson’s Practice Partner Patient Records software is designed with a number of tools including automated progress note templates; evidence-based content at the point of care; electronic prescription capabilities; orders and results and automated health maintenance reminders. In addition to the specific CCHIT 2008 certification requirements, Practice Partner Patient Records, Version 9.3, introduces a new set of powerful tools providers can use for patient care. Key new features include: support of CCD (Continuity of Care Document) allowing the import and export of patient data from Practice Partner to other EHRs and PHRs; Drug Dose Calculator allowing easy calculation of drug dosage based on the patient’s weight; integration with UpToDate Online, providing Web-based access to the pertinent evidence-based content from within the Practice Partner software; and integration with Welch Allyn CardioPerfect Workstation, allowing the collection and storage of 12 lead ECGs from the Practice Partner software.
Radiologists at Scottsdale (Arizona) Medical Imaging (SMI) turned to HP to update its computing platform to handle the thousands of high-resolution images per day, on-site across its ten outpatient radiology imaging centers. By updating its legacy systems with HP workstations and powerful new desktop PCs, SMI was able to: expedite patient diagnoses; improve the capturing and processing of data so that radiologists can quickly interpret the data; and create an integrated, high-performance computing platform to power its Picture Archiving and Communications System (PACS) from GE Healthcare, enabling radiologists anywhere on the company’s network to call up studies for review, evaluation and diagnostics. More specifically, SMI leverages the dual-core processing power and space-savings features of HP’s small form factor desktop PCs for imaging applications that are typically supported by Workstation class machines.
The Bronx (NY) Regional Health Information Organization (RHIO), representing 80 percent of the providers serving the borough’s 1.36 million residents, has gone live with the Initiate Health Information Exchange solution. Providers at 125 care locations in the Bronx now may access patients’ clinical data with appropriate patient consent through the Initiate Health Information Exchange solution. Authorized physicians and nurses have the ability to view a patient’s medical records from across participating hospitals, ambulatory care centers, physician offices and long-term and homecare services. As part of the Bronx RHIO implementation, the Initiate Health Information Exchange solution helps participants accurately identify a patient at the point of service by matching, linking and locating a patient’s records from across the network of health care systems. Initiate software also integrates with the dbMotionT solution, which serves as the interoperability and health-information-exchange platform for some of the world’s most advanced health information networks and delivery systems and facilitates secure access to integrated medical records for the Bronx RHIO. The combined solution helps improve efficiencies, increase patient and provider satisfaction, reduce errors that result from poor data quality and create an interoperable environment that allows organizations to better serve their communities.
Lenox Hill Radiology in Manhattan has chosen the MedInformatix RIS (Radiology Information System), an end-to-end clinical and business package. MedInformatix, based in Los Angeles, is a provider of a full range of Enterprise Practice Management (EPM) and Electronic Medical Records (EMR) software. As with its similar products for oncology, cardiology, orthopedics and other specialties, MedInformatix’ RIS is a standards-based package that operates from a single Microsoft SQL database. Efficiency took another major step forward when in April of 2007, MedInformatix recommended that Lenox Hill enhance its RIS with the ZirMed Web-based revenue lifecycle management system. Lenox Hill has seen a reduction in accounts receivable days of roughly 40% since integrating ZirMed with MedInformatix’ RIS. Since going paperless, the practice has grown by 200% without hiring additional office staff; what’s more, workflow efficiency has actually increased.
StatCom has announced the findings of the 2008 National Survey on Patient Flow Challenges and Technologies, an independent, nationwide survey of more than 200 healthcare executives. According to the findings, the overwhelming majority of U.S. health care executives (89 percent) reveal their facility has poor patient flow. StatCom’s 2008 National Survey on Patient Challenges and Technologies was designed to capture the thoughts and opinions held by U.S. health care executives on issues facing their facilities regarding patient flow and technology. Results of the study can be downloaded at http://www.statcom.com/survey/national-survey-2008.aspx.